Intervention Addresses Opioid Delivery in Pediatric Fractures

Authors discuss process that leads to faster treatment in children with extremity fractures

TUESDAY, Dec. 14 (HealthDay News) -- A quality- and process-improvement effort can lead to improved timeliness of pain management in children with clinically apparent extremity fractures who present to the emergency department, according to research published online Dec. 13 in Pediatrics.

Srikant B. Iyer, M.D., M.P.H., of the Cincinnati Children's Hospital Medical Center, and colleagues discuss an approach that has been used to reduce delays for intravenous opioid delivery in this population of children.

The intervention focused on a standardized initial assessment, shared awareness among providers of patients in need of prompt intravenous (IV) opioid treatment, a standardized ordering process, and coordination of necessary personnel and resources to provide IV opioid delivery. After the process was implemented, the researchers found that 95 percent of patients with long-bone extremity fractures who were treated with IV opioids received a first dose within 45 minutes of arrival, compared to an average of 20 percent before the intervention.

"By applying quality-improvement methodology, we were able to design a system capable of rapidly assessing and treating these children. We were successful in improving the initial care of a specific subgroup of patients. Our next challenge is to simultaneously improve care among varied and multiple subgroups of patients who present to the emergency department with severe pain," the authors conclude.